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Good Samaritan Society - Home Care

(763) 546-90204080 W Broadway Ste 132, Robbinsdale, MN 55422
CMS Certification Number 248086 · Non-Profit · Medicare-certified since 05/18/2005
9deficiencies since 2018
1serious
4inspections
4.5CMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2025-08-20

· Recertification · 5 deficiencies · CMS source report (PDF)
Moderate Encoding And Transmitting Oasis

The agency failed to encode and electronically transmit completed OASIS assessments to the Center of Medicare and Medicaid (CMS) system within 30 days of completing the assessment of the for 6 of 6(P18, P19, P20, P21, P22, P23) patients reviewed.

Source: CMS Form 2567, inspection 2025-08-20, tag G0372 · view on CMS
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Minor Provide Contact Info Other Services

The agency failed to provide 1 of 2 patients (P17) with information required related to other available home care providers, at the time of a agency-initiated discharge.

Source: CMS Form 2567, inspection 2025-08-20, tag G0468 · view on CMS
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Minor Rn Performs Assessment

The agency failed to ensure each patient had an initial assessment visit for resumption of care within 48 hours of the patient's discharge from the hospital for 1 of 2 patients (P15) reviewed in the sample.

Source: CMS Form 2567, inspection 2025-08-20, tag G0514 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to ensure medications were reconciled and/or set up as ordered for 2 of 7 patients (P6, P8) whose medications were reviewed during home visits and record review.

Source: CMS Form 2567, inspection 2025-08-20, tag G0536 · view on CMS
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Minor Only As Ordered By A Physician

The agency failed to initiate and provide services as ordered on admission for 1 of 7 patients (P6) whose orders were reviewed during home visits.

Source: CMS Form 2567, inspection 2025-08-20, tag G0580 · view on CMS
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Inspection 2023-04-05

· Complaint, Recertification · 1 deficiencies · CMS source report (PDF)
Minor Only As Ordered By A Physician

The agency failed to ensure medications were administered per physician's orders for 1 of 1 patient (P12) reviewed for medications.

Source: CMS Form 2567, inspection 2023-04-05, tag G0580 · view on CMS
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Inspection 2022-03-03

· Complaint · 3 deficiencies · CMS source report (PDF)
Serious text mentions immediate jeopardy Patient Rights

The home health agency (HHA) failed to meet the Condition of Participation at 484.50, Patient Rights.

Source: CMS Form 2567, inspection 2022-03-03, tag G0406 · view on CMS
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Minor text mentions immediate jeopardy Mistreatment, Neglect Or Abuse

The home health agency (HHA) failed to ensure 1 of 1 patient (P1) was free from neglect of care when staff left P1 lying at the bottom of the shower tub alone and unattended and was found by another caregiver with water up to his ears, and appeared confused.

Source: CMS Form 2567, inspection 2022-03-03, tag G0482 · view on CMS
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Minor Immediate Reporting Of Abuse By All Staff

The agency failed to report immediately to the State Agency (SA) an allegation of neglect of care for 1 of 1 patient (P1) reviewed for patient rights.

Source: CMS Form 2567, inspection 2022-03-03, tag G0488 · view on CMS
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Inspection 2020-05-29

· Focused Infection Control, Other-Fed · no deficiencies cited · CMS source report (PDF)